Health Report, 1896: Zymotic diseases

In March of 1897, the Public Health Department, which at that time was situated in West Bell Street, issued the ‘Vital Statistics’ report for Dundee for the previous year to the town Council’s sanitary committee. In 1896, the population was estimated at 161,620 (in 2014, the estimate was 141,870), with the number of registered deaths noted as 3103 (in 2014, the number of deaths in the city was 1604). The report refers to the number of deaths from ‘Zymotic’ diseases, which is the 19th century medical terminology for acute infectious and contagious diseases.

Diseases are mainly spread by infected water droplets and air transfer such as coughing and sneezing, blood and faeces, as well as via contact with infected skin, clothing or objects. Nothing was particularly clean, which made almost everything a perfect breeding ground for a multitude of bacterial nasties. Children were particularly vulnerable to disease, with 151 of the reported 3103 deaths being of children under the age of 5. This made up around 5% of the overall deaths in Dundee in that year.

We have listed them according to their death rate, from highest to lowest.

Whooping Cough – 60

The report mentions the prevalence of Whooping Cough at the start of 1896, and also goes on to state that the record is most likely inaccurate due to the fact that, at the time, Whooping Cough was not an infectious disease that had to be notified to authorities. Because of this, many cases of infection and subsequent death simply would not have been registered. As the name suggests, Whooping Cough is associated with a persistent cough and a very distinct sound. It is a highly contagious disease, which claimed 61,000 lives worldwide in 2013. Symptoms begin much like those of a cold, but gradually becomes worse as you struggle for breath. In small children, breathing can stop altogether for periods of time, resulting in death. Even now, an estimated 16 million people around the world are diagnosed with Whooping Cough every year. In 1896, 25 children under the age of 1 year died from Whooping Cough, with a further 33 deaths attributed to children between 2 and 5 years old. Only 2 deaths were not in this age range from a total of 60. 37 of those deaths happened in the first two months of the New Year.

Measles – 41

The second-highest cause of deaths in the infectious diseases category was due to measles. It is reported that from May to July of 1896, there was an epidemic (albeit mild) of measles in the East of the city. Of the 655 cases of measles reported during that year, the epidemic counted for 438 of them. Considering that only 41 deaths were registered due to measles, we could assume that the medical professionals had this well under control. However, the report did say that it was a ‘mild’ epidemic, so perhaps, on this occasion, we just got lucky. Measles is an airborne disease and can bring a variety of major health complications such as blindness, inflammation of the brain and, in severe cases, death. It’s not the ‘spotty’ disease we seem to know it as, but is in fact a highly effective killer with children as its main target. Currently, around 85% of children globally are immunised. Unlike many other diseases, you can only catch measles once. In the report, all deaths in Dundee in 1896 were of children under the age of 5.

Typhoid Fever – 23

Typhoid Fever (Typhoid) also increased that year by around 24 cases, with the autumn season playing a key part in the spread of the disease. A scandal over contaminated milk that had been supplied (unknowingly, we assume) by a local farm, directly causing 3 deaths was also noted, but, in spite of, and despite this, the death rate was fairly low overall. Typhoid means “resembling Typhus”, and the symptoms are pretty dire, including (but not limited to, or exclusive) intestinal haemorrhaging, respiratory disease, delirium and inflammation of the heart.

Diarrhoea – 23

Diarrhoea was the 4th biggest recorded killer in Dundee in 1896, and was added to the report due to the ‘action of micro-organisms’. As strange as it may sound, death from diarrhoea was actually a thing. Acute diarrhoea leads to dehydration and a loss of valuable minerals, ultimately resulting in malnutrition. Death is usually due to dehydration, which is a symptom of diarrhoea. With lack of sanitation, nutrition or clean water, sufferers were likely to be in extreme discomfort in their final days. The report goes on to state that, of the 23 reported deaths, 14 of them happened during the autumn months. Bizarrely, there seems to be no correlation between this event and the scandal of the milk farm incident which happened at the same time. The increase in deaths was put down to seasonal changes with no mention of the possibility that the infected milk could have also caused some of these deaths. 17 of the 23 recorded deaths were of children, 14 of which were under the age of one.

Diphtheria – 21

An antitoxin treatment for Diphtheria was hailed as the reason for the low number of infections registered, with 92, but as we can see, there were 21 deaths still recorded, taking the mortality rate of the disease to over 20%. A vaccine was not introduced for this moisture-borne killer until 1942, and, until then, Diphtheria claimed an annual death-rate average of around 4000 people in the UK. Even today, with full medical treatment, there is still a 5 – 10% risk of death. Symptoms include fever, sore throat, increased heart rate and nausea, but the real kicker is in the powerful toxin produced by the Diphtheria bacteria. The toxin attacks and destroys the cells in all of the airways, and, as they die, they form a membrane which can attach to the throat and cause death by choking. If the infection reaches the heart, it will cause heart failure and death (if the choking hadn’t already got you by then). In 1896, 19 of the 21 recorded deaths were of children aged 5 and under. As you can probably tell, the report makes for pretty grim reading.

Scarlet Fever – 19

In December of 1896, there were 73 cases of Scarlet Fever reported – the highest month of the year. For the year in total, the number was 422. Despite there only being 304 cases being reported the previous year, the low death rate showed that it was not a major killer, and indicated that the strain may have been milder that year. Again, a high proportion of deaths were of children under the age of 5, with 13 of the 19 reported fatalities being within this age range. Scarlet Fever is a ‘flesh-eating’ infection, and amongst the most dreaded of all ailments, capable of wiping out an entire family of children in a matter of days. Symptoms included the obvious red rash and bright red tongue, but also included paranoia, hallucinations, pneumonia and meningitis. Imagining an adult going through something like this is harrowing enough, but to think of those young children suffering in such a horrendous way is something altogether more distressing.

Typhus Fever – 2

The 2 deaths attributed to Typhus Fever were in Hilltown and Lochee, in March and May respectively. In the first case, the patient had been ill for a week before seeking medical help. Unfortunately, they died on what was believed to be their 12th day after contracting the disease. Typhus is transferred to humans via animal parasites such as ticks, lice and fleas. Flu-like symptoms are followed by a rapidly-spreading rash, which can then lead to light sensitivity, an altered mental state, and in some cases, coma. Untreated, the skin can become blistered and gangrenous, causing necrosis and a build-up of lethal toxins in the bloodstream. Definitely not a nice way to go!

In more recent times, statistics show that, between the years 2012 and 2014, there were 38 deaths recorded in Dundee City involving children under the age of 14, with a city-wide death-rate of 4842. In adults, most of the causes of death have remained the same, with cancer topping the list, followed by circulatory disease, respiratory diseases, digestive diseases, external causes and ‘other’. Maybe we haven’t learned as much about healthier living as we thought we had!

References:

‘City of Dundee Report of the Medical Officer of Health for the year ending 31st December 1896.’ (Dundee City Archives)

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